Advances and Considerations in Obturating Materials and Techniques in Primary and Permanent Teeth- A Comprehensive Literature Review

Root canal obturation is a critical determinant of endodontic success, aiming to three-dimensionally seal the disinfected root canal system to prevent reinfection and promote periapical healing. This comprehensive review elucidates the advances and considerations in obturating materials and techniques for primary and permanent dentitions, which present distinct physiological and clinical demands. For primary teeth, the paradigm emphasizes resorbable, biocompatible materials—such as zinc oxide eugenol, iodoform-based (e.g., Vitapex, Endoflas), and emerging nanoparticle-enriched pastes—that harmonize with physiological root resorption while providing effective antimicrobial action. Techniques like the Pastinject system demonstrate superior fill quality. In permanent teeth, gutta-percha remains the core material of choice, increasingly used in conjunction with advanced sealers, particularly bioactive bioceramics, which offer superior sealing through hygroscopic expansion and excellent biocompatibility. Obturation techniques have evolved from cold lateral condensation to sophisticated warm vertical compaction and carrier-based systems that enhance adaptation and create a more homogeneous fill. Common causes of failure, including underfilling, overfilling, and void formation, are discussed alongside prevention strategies that underscore meticulous technique and appropriate material selection. The future of obturation points towards ’smart’ bioactive materials and the integration of digital technologies, promising more predictable and biologically harmonious outcomes. Ultimately, evidence-based selection of materials and techniques, tailored to the specific demands of each dentition, is paramount for optimizing the long-term success of endodontic therapy.